The purpose of this research is to increase the number of women in North Dakota who a) obtain a first-time mammography and b) continue to obtain screening at appropriate intervals. Communities in one-half of the state will receive a community intervention, whereas communities in the other part of the state will serve as on-treatment controls. The community intervention will begin with a year-long media campaign followed by two years of community activities led by volunteers from state American Cancer Society units. In the final year, we will begin to examine maintenance of the intervention effects. The focus of the community intervention will be on increasing perceptions of personal vulnerability while simultaneously emphasizing the effectiveness of screening techniques. The primary outcome data will be cross-sectional survey reports of whether women have obtained a mammography screening in the previous year. We will also measure reported frequency of breast self-exam and clinical exams, and we will collect a variety of process measures (e.g., perceived vulnerability). In addition, interviews will be conducted with a randomly selected subset of women to provide longitudinal data related to perceptions of the media campaign, the action intervention, and reasons why women have (or have not) participated in screenings. The results of this study should address the role of vulnerability perceptions in promoting health protection action and shed light on whether a community cancer-prevention program targeted to rural areas can be effective. The research may have the added health benefit of reducing cancer mortality among women who are screened and who would not have undergone screening without this campaign.